Provider Demographics
NPI:1689633729
Name:WANG, HUAN-YOU (MD, PHD)
Entity Type:Individual
Prefix:
First Name:HUAN-YOU
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WEST ARBOR DRIVE 8320
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8320
Mailing Address - Country:US
Mailing Address - Phone:619-543-5966
Mailing Address - Fax:
Practice Address - Street 1:200 WEST ARBOR DRIVE 8320
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8320
Practice Address - Country:US
Practice Address - Phone:619-543-5966
Practice Address - Fax:619-543-3730
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86331207ZH0000X
TX41225207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177808601Medicaid
8G2761Medicare ID - Type Unspecified
I47840Medicare UPIN